As Cathy Lilly folded into downward dog at a workshop in January, a novice instructor, eager to help, lifted Ms. Lilly’s thumbs and angled them forward. Her thumbs are still recovering from the strain.
Ms. Lilly, 53, a yoga teacher with more than two decades on the mat, also once injured her rotator cuff jumping distractedly into plank pose. And after another instructor suggested she kiss her knee while in heron pose, her hamstring suffered the consequences.
Isn’t yoga supposed to be good for you? After all, doctors prescribe it to injured athletes and cancer patients. And while tennis players can expect ripped-up elbows and runners know they may blow out their knees, yogis don’t usually anticipate having to hobble off their mats.
It is this “do no harm” mind-set that can lead to strained backs, pulled knees, aching wrists and slipped discs. Ms. Lilly is part of a growing roster of yoga practitioners on injured reserve.
“Yoga is a good thing, so you tend to push further than you would in a sport where you are actually more attuned to injury and afraid of injuries,” said Dr. Michelle Carlson, an orthopedic surgeon at the Hospital for Special Surgery in Manhattan who specializes in arms and hands. She said she recently “saw four women in a row in my office with hand injuries from yoga.”
Nobody seems to keep careful track of the numbers. The most recent estimate comes from the United States Product Safety Commission, which tracks sports injuries: it listed 4,450 reported yoga injuries in 2006, up from 3,760 in 2004. But Dr. Carlson and several others said they had seen large increases lately, as yoga became more popular. “I have been doing this for 20 years, and I didn’t see yoga injuries 20 years ago,” Dr. Carlson said. “I can see a couple of injuries a week.”
Training for yoga teachers can vary, and classes are so large in some studios that instructors do not pay enough attention to everybody. In New York, many people approach yoga with a no-pain, no-gain mind-set, with predictable results.
Then there is the age factor: you see a fair share of middle-aged people twisting and bending and lunging, and I know from experience that a 40-something body is temperamental.
Back injuries are quite common. Positions like upward dog and cobra, requiring backbends, can aggravate the spine. Others that call for elongating the back, like seated forward bend, can wreak havoc on discs. Rotator cuffs and wrists can get battered during plank poses and chaturangas, which are like push-ups, while knees are susceptible to the lotus position, hero’s pose and the warrior positions.
The headstand — a more advanced move — is an equal opportunity offender. If done improperly, it can roil your back, neck, shoulders and wrists.
Then there are the freak injuries. A woman in crow pose fell over and broke her nose. Ouch.
“The most common form of injury is the overzealous student,” said Dr. Loren Fishman, a spine specialist, yoga teacher and medical director of Manhattan Physical Medicine and Rehabilitation. “The second most common reason for injury is poor alignment, and that is usually crummy teaching.”
The best way to avoid injury, particularly if your body is creaky, is to take it slow and make sure to nail the fundamentals, experts said. Injuries can happen with all forms of yoga, but one of the safer approaches is Iyengar, which moves at a slower pace, focuses meticulously on proper alignment and uses props. Iyengar teachers also undergo rigorous training.
At one recent class at the Iyengar Yoga Institute in Chelsea, we spent about 20 minutes on extended side angle pose; I learned quite a few things in those 20 minutes. (Anusara, based on Iyengar, is similar in its attention to alignment.) I love vinyasa — the breathing, the pace — but it can flow too quickly, and its many chaturangas have sometimes strained my wrists. Since classes are large, adjustments from instructors can be few and far between. Also, I find the lack of mirrors in most yoga studios cuts both ways: You’re not obsessed with your own image, but you can’t see your body in a pose.
The other day I took a class in Union Square with Ellen Saltonstall, an acclaimed Anusara teacher who recently wrote a book with Dr. Fishman on yoga for osteoporosis. Her class is slow enough that you can settle into the right alignment. Afterward, she critiqued my push-up pose. My elbows were not at right angles, and she cautioned me about dropping too far down. She also gave me stretches for my wrists.
“Precision,” she said, “is important.”